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This study was a longitudinal extension that examined trajectories of adult offending in a sample of women who participated in a randomized intervention trial aimed at reducing conduct problems and delinquency during adolescence. In the original study, girls ages 13 to 17 who had been referred for out-of-home placement due to chronic delinquency were randomly assigned to participate in services as usual (group care; GC) or in Treatment Foster Care Oregon (TFCO), previously known as Multidimensional Treatment Foster Care. TFCO is an evidence-based intervention designed as an alternative to residential care or incarceration for juvenile justice-involved adolescents and has been found to be effective in reducing youth delinquency, deviant peer affiliation, adolescent pregnancy, as well as longer term effects in reducing young adult criminal involvement, depression, suicidality, and substance use problems. The current study further evaluated outcomes in this sample of women at least six years after the last follow-up by examining trajectories of offending and involvement with the criminal justice system, health-risking behaviors, trauma, and long-term health outcomes, including biological indicators.